• Title/Summary/Keyword: High frequency symptom

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The clinical study of Myasthenia Gravis (중증근무력증(重症筋無力症)에 대(對) 임상적(臨床的) 연구(硏究))

  • Chae, Byung-Yoon
    • The Journal of Korean Medicine
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    • v.17 no.1 s.31
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    • pp.190-211
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    • 1996
  • Generally the Myasthenia Gravis is classified into two of hereditary factor and acquement. Aquired Myasthenia Gravis was Quite well known to be caused by the autoimmune mechanism. Not in accurateness, on the hereditary, acetylcholine receptor antibody was to be analyzed very high in their parents and brothers. Also Myasthenia Gravis is a chronic disease characterized by voluntary muscle weakness and fatigue. above all, ocular Myasthenia Gravis is characterized clinically by blepharoptosis and external ophthalmoplegia and to be showed abut 90% cases and so oriental medicine can not but deal with myasthenia gravis at blepharoptosis. Accordinglv 20 out patients with Myasthenia Gravis were clinical study and observation as to the sex, age, progress state of MG, blood type, history, main symptom, liking for warm and cool food and tepidity, state of pulse, treatment of acupuncture and administration of oriental medicine etc. The results were as follows. 1. There was investigaed on the frequency of attack for sex, age, oculus dexter, oculus sinister, oculus uterque. Among the 20 patients, the number of female were 60% with 12 cases and male were 40% with 8 cases, therefore it was the rate of 6 : 4. the patients under 10 ages and 40 ages were 20% with 4 cases, 10 ages and 50 ages were 15% with 3 cases, 20, 30, 60 ages were 10% with 2 cases. And then oculus uterque was 90% with 18 cases, oculus sinister was 10% with 2 cases and oculus dexter were none of them. 2. Stage I were 50% with 10 patients, stage $II_A$ were 30% with 6 patients and stage $II_B$ were 20% with 4 patients, on the clinical stage and too class I were 20% with 4, class II were 45% with 9, class III were 35% with 7, in the functional activity the patients with chest heavy were 15% with 3 and hyperthyroidism were 10% with 2. 3. Hospital which patients had used to before came to this hospital were 10 university hospital and 6 local clinic. 4. The duration of disease was from 3 months to 30 years, the patients suffering between 3 months and within 1 year were 25% with 5 cases, 1-2 years were 30% with 6 cases, therefore within 2 years were 55%. 4-5 years were 15%, over 7 years were appeared less than 10%. 5. In the main symptom, all of patients were appeared to be heavy in opening their eyes the patients with blephroptosis were 70% with 14 cases on the oculus uterque, oculus sinisterf and oculus dexter, there were 20% with 4 eases each other in the oculogyation incomplete. visual failing, ophthalmoxerosis, strabismus etc and indigetion, frequency of urine(feel hurt), mild stools(or diarrea), oversensitiveness etc. but in addition, all of the other were 10%. 6. In the distribution of blood type, 0 types were 45% with 9 cases, A types were 25% with 5 cases, B and AB types were 15% each other. 7. For the rates of patients of liking for warm and cool food or tepidity, patients of liking for warm food possess 45% with 9 cases, and cool food possess 35% with 7 and tepidity possess 20% with 4, and then most of patients liking for warm food were females and cool food were much more males than females. 8. Hyunsae(弦細) were 40% with 8 cases, Buhurl(浮滑) were 20% with 4 cases, Hyunsak(弦數) were 15% with 3 cases, and in addition, the others were 10%, among 7 types of pulses. 9. The patients with less than 1 week were 40% with 8 cases, and there were female most of them and over 4 weeks were 20% and 1-2weeks were 15%, in the duration acupuncture treatment. 10. 15 kinds of prescriptions were administrated with oriental medicine from 1 week to 20weeks 1_2 weeks were 25.71% with 9 cases, 3 weeks were 17.14% with 6 cases and 6 weeks were 11.42% with 4 cases and also Gamibaetaugunbitang(加味培土健脾湯) were 28.57% with 10 cases, Gamijeounyongtang(加味正容湯) were 14.28% with 5 cases, Gamibojoongyigitung (加味補中益氣湯), Gamiyinsamyangyoungtung (加味人蔘養榮湯) were 8.57% with 3 cases each other and also Gamisamgitung (加味蔘?湯), Gamisamuloajatung(加味四物五子湯) Gamigoudungum (加味鉤藤飮), etc were applied.

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A Study for the Development of Standardized Management Manuel in Sanhujoriwon - Centered on the Management of Women & Newborn - (산후조리원의 표준화 관리 지침을 위한 연구 - 산모와 신생아 관리현황을 중심으로 -)

  • Jung, Eun-Sil;Yoo, Eun-Kwang
    • Women's Health Nursing
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    • v.8 no.2
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    • pp.301-313
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    • 2002
  • The purpose of this study was to develop the frame for standardized manual for Sanhujoriwon by finding out the status of the management of women & newborn in Sanhujoriwon, like postpartum care center. The subjects were 95 staffs of 22 Sanhujoriwon agreed on oral consent, in Seoul and Bundang, Korea. Data were collected from Sep. 15 to Oct. 24, 2001. The instrument used for this study was a structured questionnaire consisted of 16 items of general characteristics & educational characteristics about postpartum care, 31 items of degree of management of women's postpartum care (Cronbach's $\alpha$.93 ), 24 items of degree of management of newborn's care(Cronbach's $\alpha$.94 ), 10 items of methods of management of women's postpartum care, 8 items of methods management of newborn's care. The data were analyzed by the SPSS/PC+ program using frequency, percentage, mean, standard deviation, t-test, ANOVA and Pearson correlation coefficient. The results of the study were as follows ; 1. The mean of the degree of management for postpartum women was 4.1. The mean score for the degree of management of general postpartum care for women was 4.00 & traditional postpartum care(Sanhujori) was 4.20. The degree of management of traditional postpartum care was higher than general postpartum care for women. 2. The degree of management for newborn : The mean score for the degree of management of newborn was 4.37. 3.There was a strong positive correlation between general postpartum care and traditional postpartum care($r=.744^{**}$), and postpartum mother care and newborn care($r=.798^{**}$). 4.The basic frame for the management of the women and newborn in Sanhujoriwon. 1) For women: Integrated postpartal care Physical management : Vital sign & BP check, contraction of uterus, form and amount of lochia, management of personal hygiene, management of breast & breast-feeding, management of postpartum exercise, prevention of infection, symptom & sign of high risk and prevention & management of high risk condition; Emotional-psychological management: assessment and management of mother-baby attachment, emotional state; Educational management : education of vaccination schedule, urinary incontinence, rearing infant, breast-feeding ; and Environmental management : temperature, humidity, disinfection, cleaning, light, infection control integrated with 6 principles of Sanhujori. 2) For newborn Physical management : check of vital sign, management of umbilical cord, jaundice, prevention of infection, management of diaper rash; Emotional-psychological management : assessment of sleep, crying, activity, response of mother-baby attachment; and Environmental management : temperature, humidity, disinfection, cleaning, light, infection control integrated with 6 principles of Sanhujori. In conclusion Sanhujoriwon must be health care center for the postpartum women and newborn. Therefore, the establishment of various laws and regulations in such a way to meet the realistic needs of Sanhujoriwon as a health care center for women and infants future health should be done. The standardized management manual based on the results is absolutely required above all.

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Analysis of High-Resolution Manometry Results in LPRD Patients Who Do Not Response to PPI Medication (양자펌프 억제제에 반응을 보이지 않은 인후두 역류질환 환자에서 고해상도 식도 내압검사의 분석)

  • Lee, Chang-Hee;Lee, Hyun-Sub;Jin, Sung-Min;Lee, Sang-Hyuk
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.23 no.1
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    • pp.43-47
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    • 2012
  • Background and Objectives : Laryngopharyngeal reflux disease (LPRD) originates from regurgitation of gastric contents to the laryngopharynx, and it is relatively common disease in otolaryngology. Proton-pump inhibitor (PPI) medication is frequently using treatment method in present time, but controversies exist regarding treatment for it. High-resolution manometry (HRM) system is a newly developed device that using 36 channels and pressure topography plotting program, checking the function and status of esophagus. The aim of this study was to evaluate clinical usefulness of HRM in LPRD patients who do not response to PPI medication. Materials and Method : From July 2009 to July 2010, a total of 99 patients who were suspected LPRD according to symptoms (Reflux Symptom Index >13) and laryngoscopic findings (Reflux Finding Score >7) were retrospectively enrolled in this study. Patients were consisted of 31 men and 68 women, the mean age was 51.8 years, the mean BMI was 22.46. Patients have taken PPI medication for 2 months, after medication, they performed HRM. Comparative analysis was performed with results of the difference in symptoms. Results : In 99 patients, 37 patients (37.4%) show not improvement of LPRD symptoms after PPI medication. Among them, 18 patients (48.6%) showed abnormal findings that were classified as Peristaltic dysfunction (38.9%), Diffuse esophageal spasm (11.1%), Relaxation impairment of LES (11.1%), Achalasia (5.6%), Hypotensive LES (11.1%), Relaxation impairment of UES (11.1%), Nutcracker esophagus (5.6%), Decreased resting pressure (5.6%). Other 62 patients (62.6%) show improvement of LPRD symptoms, 23 patients (37.1%) showed abnormal findings. Most common finding was Peristaltic dysfunction (43.4%) More prevalent abnormal findings of HRM were found in patients who revealed no response to PPI medication (48.6% vs. 37.1%), but it does not reach the statistical significance. Conclusion : Although statistical significances is not showed, the difference observed in the frequency of HRM abnormal finding between response and no response for PPI medication. It has been estimated that HRM may be used to determine differential diagnosis in patients with LPRD. Further studies in lager population containing normal controls will be needed to prove clinical usefulness.

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Analysis of High-Resolution Manometry Results in LPRD Patients who do not Response to PPI Medication (양자펌프 억제제에 반응을 보이지 않은 인후두 역류질환 환자에서 고해상도 식도 내압검사의 분석)

  • Lee, Chang-Hee;Lee, Hyun-Sub;Jin, Sung-Min;Lee, Sang-Hyuk
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.22 no.2
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    • pp.151-155
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    • 2011
  • Background and Objectives : Laryngopharyngeal reflux disease (LPRD) originates from regurgitation of gastric contents to the laryngopharynx, and it is relatively common disease in otolaryngology. Proton-pump inhibitor (PPI) medication is frequently using treatment method in present time, but controversies exist regarding treatment for it. High-resolution manometry (HRM) system is a newly developed device that using 36 channels and pressure topography plotting program, checking the function and status of esophagus. The aim of this study was to evaluate clinical usefulness of HRM in LPRD patients who do not response to PPI medication. Subjects and Method : From July 2009 to July 2010, a total of 99 patients who were suspected LPRD according to symptoms (Reflux Symptom Index >13) and laryngoscopic findings (Reflux Finding Score >7) were retrospectively enrolled in this study. Patients were consisted of 31 men and 68 women, the mean age was 51.8 years, the mean BMI was 22.46. Patients have taken PPI medication for 2 months, after medication, they performed HRM. Comparative analysis was performed with results of the difference in symptoms. Results : In 99 patients, 37 patients (37.4%) show not improvement of LPRD symptoms after PPI medication. Among them, 18 patients (48.6%) showed abnormal findings that were classified as Peristaltic dysfunction (38.9%), Diffuse esophageal spasm (11.1%), Relaxation impairment of LES (11.1%), Achalasia (5.6%), Hypotensive LES (11.1%), Relaxation impairment of UES (11.1%), Nutcracker esophagus (5.6%), Decreased resting pressure (5.6%). Other 62 patients (62.6%) show improvement of LPRD symptoms, 23 patients (37.1%) showed abnormal findings. Most common finding was Peristaltic dysfunction (43.4%) More prevalent abnormal findings of HRM were found in patients who revealed no response to PPI medication (48.6% vs. 37.1%), but it does not reach the statistical significance. Conclusion : Although statistical significances is not showed, the difference observed in the frequency of HRM abnormal finding between response and no response for PPI medication. It has been estimated that HRM may be used to determine differential diagnosis in patients with LPRD. Further studies in lager population containing normal controls will be needed to prove clinical usefulness.

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Risk Factors of Coronary Artery Bypass Grafting According to Ventricular Function (좌심실기능에 따른 관상동맥우회술의 위험인자)

  • 이헌재;현성렬
    • Journal of Chest Surgery
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    • v.30 no.9
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    • pp.885-890
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    • 1997
  • Patients with coronary artery disease and depressed ventricular function have better longterm benefits after coronary artery bypass grafting compared with medical therapy. But operative mortality remains high. This study was designed to identify the risk factors for coronary artery bypass grafting according to ventricular function. The records of 103 patients who underwent coronary artery bypass grafting from truly 1994 to June 1996 were analysed. The patients were divided into two groups based on preoperative ejection fraction: Low EF group(Ejection fraction < 40%, n=24) and Normal EF group(Ejection fraction $\geq$ 40%, n=79). The indication of operation was significantly different between the two groups (p=0.00003). Postinfarction angina was frequent in Low EF group but unstable angina was frequent in Normal EF group. The frequency of cardiomegaly(p=0.0012), serum creatinine abnormality(p=0.0473) and preoperative use of IABP(Intra Aortic Balloon Pump, p=0.0095) were higher in Low EP group. The left internal thoracic artery was used less frequently in Low EP group(p=0.00416). The operative mortality was 8.3% in Low EF group and 5.1% in Normal EF group, but without statistical difference(p=0.5492). In Normal EF group, age (p=0.041) was identified as a significant risk factor for operative mortality. In Low EF group, age(p=0.018), preopertive use of IABP(p=0.0036), hypercholesterolemia(p=0.0007), and emergency of operation(p=0.0037) were identified as significant risk factors. Postoperative morbidity was 50% in Low EF group and 33olo in Normal EP group, but without s atistical significance(p=0.1007). These results suggest that in patients with coronary artery disease and depressed ventricular function, more aggresive coronary artery bypass grafting is needed to improve the symptom and long-term benefit.

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An Analysis of Clinical Prognosis Factors of Peripheral Facial Palsy and the Effects of Electrodiagnostic Test (말초성 안면신경마비 경과에 대한 임상적 예후인자 및 신경생리검사의 유용성 분석)

  • Ahn, Chang-Beohm;Yoon, Hyun-Min;Jang, Kyung-Jun;Kim, Cheol-Hong;Jung, Kyoung-Keun;Min, Young-Kwang;Kim, Soo-Min;Kim, Jeong-Eun;Cho, Beohm-Gyu
    • Journal of Acupuncture Research
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    • v.24 no.4
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    • pp.209-223
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    • 2007
  • Objectives : Facial Nerve Paralysis is one kind of common diseases and it can be treated by natural therapy and the efficiency of treatment is relatively high. In clinical trial, it is not difficult to find patients who were not completely recovered from Facial Nerve Paralysis, so the symptoms are fixed permanently. This leads many doctors and patients to have interests in the progress and prognosis of the disease, so this study was to analyze clinical prognosis factors and verify the effects of Electrodiagnostic Test. Methods : The 378 subjects were chosen from 987 patients who were suffering from Peripheral Facial Palsy, diagnosed with Bell's palsy and Ramsay Hunt Syndrome and had admission treatment. They got Oriental-Western Medicine Treatment within two weeks after outbreaks of the disease and treated at least over 3 weeks using Oriental-Western Medicine Treatment. Results : 1. There was a significant difference in the results of treatment according to gender, age, types of Facial Palsy, existence of Post Auricular Pain, existence of Labyrinth Symptom, HBGS, and existence of onsets of recovery as clinical prognosis factors of Peripheral Facial Palsy, However, a statistically significant difference was not shown in the results of treatment according to the position of Facial Palsy(left or right), existence of a relapse, and diabetes, hypertension. 2. As a result of overall treatment, 77.2% of patients were recovered almost entirely and 22.8% were not, and the quelae of incomplete recovery were Synkinesis, facial contracture, facial spasm, crocodile tears and scheroma in order of frequency. 3. The results of electrodiagnostic test represented useful correlation to predict the final effects of treatment. Conclusion : Based on the above results, the prognosis factors, the degree of recovery, and the sequelae of incomplete recovery were analysed and the effects of electrodiagnostic test was verified.

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Effects of Fiber Supplements on Functional Constipation (식이섬유의 섭취가 만성 기능성 변비에 미치는 영향)

  • Kim Ji Young;Kim Oh Yoen;Yoo Hyun Ji;Kim Tae Il;Kim Won Ho;Yoon Young Dal;Lee Jong Ho
    • Journal of Nutrition and Health
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    • v.39 no.1
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    • pp.35-43
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    • 2006
  • This study aimed to evaluate the effect of dietary fiber supplementation with snack type on functional constipation. We conducted a double blind case-control study with 3 groups; placebo, low dose group (LD: insoluble fiber 7 g/d + soluble fiber 1.2 g/d) and high dose group (HD: insoluble fiber 14 g/d + soluble fiber 2.4 g/d) , which were randomly assigned out of subjects with functional constipation, defined by modified Rome II criteria. We measured anthropometric parameters and evaluated the bowel movement frequency, stool type, straining, sense of complete evacuation, abdominal discomfort/pain, abdominal inflation, relief and colon transit time before, during the supplementation. Both LD and HD groups had significant improvement in straining, sense of complete evacuation and satisfactory relief compared with placebo group (p < 0.05). When subdivide by baseline colon transit time (less than 24 hrs/ 24 hrs or more and less than 72 hrs / 72 hrs or more), only HD group had significantly improvement; colon transit time recovered near by 24 hrs in subjects of 'less than 24 hrs' (from $7.57{\pm}1.40$ hrs to $25.2{\pm}3.91$ hrs, p < 0.01) and reduced in those of '24hr or more and less than 72 hr' (from $47.0{\pm}3.36$ hrs to $31.3{\pm}4.31$ hrs, p < 0.01) and '72 hr or more' (from $106.7{\pm}10.7$ hrs to $85.0{\pm}13.1$ hrs, P < 0.05) subjects. Particularly, positive effect of fiber supplementation on straining and sense of complete evacuation in test groups seemed to be greater in subjects of '24 hrs or less' and '24 hrs or more and less' than 72 hrs' than those of '72 hrs or more'. In conclusion, subjects with functional constipation, particularly those having colon transit time less than 72 hrs can significantly improve, at least in part, symptom related to constipation by fiber supplementation of snack type without serious side effects.

A Case of Clonorchis Sinensis with Multiple Low Echogenic Nodules in a Child (소아에서 진단된 다발성 저음영 결절 형태를 보인 간흡충증 1례)

  • Hwang, Young Jun;Han, Man Yong;Ha, Doo Hoe
    • Pediatric Infection and Vaccine
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    • v.8 no.1
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    • pp.123-128
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    • 2001
  • Clonorchiasis, known as the parasitic fluke in the intrahepatic bile ducts, occurs throughout Korea, Japan, Taiwan, and Vietnam with high frequency. Most of the infections follow the consumptions of raw or undercooked freshwater fish, which explains its rare occurrence to childhood even in those areas mentioned earlier above. The authors have experienced it with an 8 year old boy. Abdominal ultrasonogram revealed multiple low echogenic nodules in the right lobe of liver and lymph nodes proliferation around the porta hepatis area. And abdominal C.T. scan also found multiple low attenuated nodules with delayed enhancement in liver parenchyma with hepatomegaly and multiple conglomerated lymph nodes in porta hepatis. Both abdominal ultrasonogram and C.T. scan didn't show any dilatation of peripheral intrahepatic bile ducts. In repeated stool examination, Clonorchis sinensis eggs were found in feces and the result of the skin test for Clonorchis sinensis was positive. The patient had a history of having eaten raw pond smelt back in Cheongju a month before the symptom onset. On the basis of the patient's history and the fact that Clonorchis eggs were found in feces 3 weeks after eosinophilia and symptoms were noted, the authors estimated that the findings of the patient's abdominal sonogram and C.T. scan were the radiologic findings of the acute phase of clonorchiasis, of which no report had ever been made before. So the authors report a case of clonorchiasis with atypical radiologic findings in an 8 year old boy.

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Preliminary Study on Usual Cold or Heat as a Risk Factor for Hypertension in an University Faculty (일개 대학 교직원 집단에서 고혈압의 위험요인으로서의 평소 한열 예비 연구)

  • Jung, Kyung Sik;Kim, Yun Young;Baek, Young Hwa;Jang, Eunsu
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.33 no.4
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    • pp.226-232
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    • 2019
  • This study was aimed to reveal that the usual cold or heat state was associated with hypertension and could be a risk. We emailed educational personnel in D university to join this study and 182 subjects participated in from March to December in 2016. The usual cold or heat diagnosis was conducted by two experts who had over 10 years expertise. The blood pressure was measured from the subjected after 10 minute rest with Jawon medical device. The hypertension was diagnosed by the guide of the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. The frequency analysis was used in general characteristics, Pearson's Correlation Coefficient analysis was conducted in among continuous variables, and chi-square test was also used between hypertension and cold or heat group. Logistic regression was analyzed to generate the odds ratios (ORs) and 95% confidence interval (CI) for hypertension. The cold score was suggested to have negative association with Body mass Index (BMI, -.374, p<.001), systolic blood pressure (-.333, p<.001), and diastolic pressure (-.261, p<.001). The heat score was analyzed to have positive association with Body mass Index (.413, p<.001), systolic blood pressure (.249, p<.001), and diastolic pressure (.156, p<.001). The distribution of the cold group (35.1%) and non-cold group (64.9%) in hypertension was significantly different (p=0.18). The distribution of the heat group (62.2%) and non-heat group (37.8%) was significantly different (p=0.27). The usual cold was associated with decreased ORs (ORs 0.405, 95% CI=0.191-0.857), and usual heat was associated with increased ORs (ORs 2.327, 95% CI=1.108-4.888). However, after adjusting body mass index, sex, and smoking, the association was not significantly different. It is possible that usual cold or heat associate with hypertension. Further study is needed to show that usual heat may be a independent risk factor for hypertension through follow up design.

Clinical Features of Dietary Protein Induced Proctocolitis (식이 단백 유발 직결장염의 임상적 고찰)

  • Im, Sun Ju;Kim, Seong Heon;Bae, Sang Nam;Park, Jae Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.2
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    • pp.157-163
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    • 2005
  • Purpose: Dietary protein induced proctocolitis (DPIPC) can be considered as a cause of rectal bleeding or blood streaked stool in otherwise healthy-looking infants in the first several months of life. Failure to appreciate this entity may lead to inappropriate diagnostic or therapeutic intervention. This study aimed to ascertain the clinical features, treatment and prognosis of DPIPC. Methods: We reviewed 13 infants retrospectively, presented with bloody stool in early infancy. They were diagnosed as DPIPC clinically in Pusan National University Hospital from May 2002 to June 2004. Results: Seven males and six females were included. The mean age at onset of bleeding was $96.8{\pm}58.8days$. The mean frequency of hematochezia was $2.6{\pm}2.5$ times a day. Duration from onset of symptom to diagnosis was $35.5{\pm}55.0days$ and duration from onset of symptom to resolution of bleeding was $58.7{\pm}67.0days$. Nine (69.2%) were exclusively breast-fed infants and two (15.4%) were formula-fed infants. All but one infant did not have family history of other allergic diseases. A dietary history of ingestion of cow's milk, nut or shellfish was present in three mothers. Peripheral eosinophil count was normal to slightly elevated (total WBC count $10,555{\pm}3,145/mm^3$, relative eosinophil count $6.3{\pm}3.0%$, absolute eosinophil count $659.0{\pm}532.2/mm^3$). Sigmoidoscopy revealed lymphonodular hyperplasia with surrounding hemorrhagic spots in the rectosigmoid colon in 6 infants. Histopathologic finding of colonic biopsies in 5 infants showed chronic inflammation with lymphoid follicular hyperplasia (5 infants), crypt abscess (3 infants), or mild infiltration of eosinophils (less than 20/high power field) in the lamina propria. Spontaneous resolution of rectal bleeding occurred in all infants without dietary change or medicine. Conclusion: Most infants with DPIPC experience a very benign course and have spontaneous resolution of rectal bleeding without changes in the mother's diet. In the case of strong evidence for DPIPC we suggest deferring further invasive investigation and continuing breast feeding.

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